New PSC Support Research Uncovers Critical Link Between Liver and Small Intestine
PSC Support has funded important research to better understand the connection between the liver and the digestive system in primary sclerosing cholangitis (PSC). The digestive system is extremely complex, and while research has historically focused on the large intestine (bowel) due to its known link with inflammatory bowel disease (IBD), this study specifically focused on the small intestine. Led by Dr Nicholas Ilott, the team investigated how the flow of bile acids from the liver might affect the small intestine’s ability to function.
How does PSC affect the small intestine?
The small intestine has previously been overlooked in PSC research because it does not usually show obvious symptoms. Dr Ilott hypothesised that a reduced flow of bile acids from the liver to the small intestine in PSC may still impact the barrier function of the small intestine, even without visible signs of disease. Bile acids, produced by the liver, help to digest fats and keep the intestinal barrier intact.
What is the link between liver function and gut protection?
Using advanced scientific methods (single cell RNA-sequencing), the team confirmed that cells forming the small intestinal barrier in people with PSC express lower levels of protective genes. These lower levels were more pronounced in patients with particularly high levels of the liver enzyme, alkaline phosphatase (ALP). Using models of PSC, Dr Ilott was able to show that these protective genes are decreased when the liver isn’t functioning as it should and this is probably because of bile acids.
What do these findings mean for future PSC treatments?
This initial work could be a key target for new medicines.
Dr Ilott commented, "Our initial insights that have been aided by funding from PSC Support suggest that we may be able to target the small intestine – perhaps by changing the gut microbiome – to stop PSC from progressing".
The team will now pursue further work to determine if these protective mechanisms are critical in the overall progression of PSC.
Next Steps
PSC Support is proud to fund research that is unlocking fundamental understanding of PSC and its potential drivers. We need your help to continue funding vital projects like this.
Turning Ambition into Action in 2026:
Our Fortnight in Focus
At PSC Support, we want a world without PSC. We work tirelessly behind the scenes to drive research and improve lives. Here is a snapshot of what we've been up to:
Organisational excellence: We simplified our personal data consent process and streamlined how we record patient stories to ensure that the lived experiences of our community are captured accurately and securely to inform future work.
Progressing Research: We coordinated a series of upcoming meetings with international researchers and pharmaceutical companies, which supports better informed decisions for people with PSC, research, or care. This groundwork helps keep PSC research focused on the primary needs of the patient community.
Progressing Research: We reviewed and contributed to scientific abstracts and posters for the upcoming EASL international liver congress, which strengthens the quality of future research for people with PSC, research, or care.
Progressing Research: We engaged with the MHRA to prepare for the upcoming national consultation on rare disease therapies, representing PSC patients in the wider community. Maintaining this direct dialogue ensures our organisation is prepared to respond formally and protect the interests of those living with PSC
Improving Care: We presented about what it is really like to live with PSC to gastroenterologists This first-hand insight equips healthcare professionals to better understand the day-to-day challenges of PSC.
Income Generation: We secured a place in the prestigious Big Give Small Charity Week match-funding campaign, so that we can maximise future donations from our supporters as every donation between 22 and 29 June will be doubled!
Progressing Research: We recruiting for a research and advocacy officer to expand our core team. This additional capacity ensures we can better support scientific studies and represent the patient voice at every level.